Reasons Why Your Anti-Androgens For Hair Loss May Have Stopped Working

[d&t]

 

When I was 37 I began estradiol valerate injections  Along with these injections that I received every 14 days, an angel from the Nassau County Medical Center also prescribed- Aldactone. 

When I began this regimen the androgenic hair loss was so enormous and unceasing that I’d constantly pray to fall asleep and never wake up. But in 3 weeks, along with beautifully soft skin, at least 60% of body hair fell out or had miniaturized. Then after two months I grew back so much scalp hair that I didn’t recognize myself. To this day it was the happiest time of my life. I looked so damned good that I couldn’t wait to get home from work and put on that lovely black evening dress that hung in the closet for two years. And if I had the budget back then I’d have gone shopping for other formal and casual workaday attire. What’s more, that damnable morning wood and lingering libido that lurked about me for years had suddenly vanished. I wasn’t even expecting that bonus! It was just heavenly. I felt so light and free; like a big weight was thrown off my frame. I simply couldn’t have dreamed of a happier total transition.

When Dr. R. had to excuse himself from continuing my treatments, after which I then endured many years commuting to Manhattan,            I continued every 14 days with the injections, even after the orchiectomy when I was 44. I’m well past 50 and the hair loss has seriously resumed over the last year or so. However, the loss has been especially severe these last 8 months, perhaps due to a barrage of tremendous and nearly unrelenting stress, which I know is very bad, as it can induce the zona recticularis to secrete androgens. https://en.wikipedia.org/wiki/Zona_reticularis

Accordingly, like most of us, I’ve been using one or more anti-androgens ever since transitioning. At first it was Aldactone. I was never quite sure if it was helpful against the hair loss. Five or six years later, Dr. Cheslow prescribed Proscar-not the lower strength Propecia. That caused very noticeable regrowth where my hairline was actually extending as low as my earliest recollection.

But sometime later Proscar’s effectiveness began to fade and hair loss had returned, even though I had been using  minoxidil twice daily along with the Proscar, and thereafter. 

Then in 2002, SKG began marketing Avodart, which I was lucky enough to begin using that same year. I was even luckier in that even at the standard dose the hair regrowth was very good to excellent. The only downside was when my dermatologists could no longer issue me samples, where even with my health insurance the Avodart was very hard to afford. Still, I kept up the treatment for years, and while also using generic minoxidil all along.

Also, around 2004, I began to notice libido creeping back to where now it’s again, even at my age, an ugly annoyance.   

And so, like the other anti-androgen regimens, I began to go through cycles of Avodart losing and regaining its effectiveness, even while continuing to use minoxidil the whole time. Might this have happened because, due to other expenses, I could no longer afford the Avodart and had to go with the generic Dutasteride? While the latter is very affordable, would anyone know if generic Dutasteride is often less effective than Avodart against androgenic hair loss?

In December 2015, Dr. D. a Garden City dermatologist prescribed minoxidil + progesterone. I was lucky enough to find a local compounder who was way cheaper than all others within 50 miles. Unfortunately, using the topical the same way as I had always used the Minoxidil (applied to five sides of the head and gently but firmly pressed-not rubbed-in) quickly proved unaffordable for the prescribed twice daily sessions, even with my insurance. So I applied it mornings only. Amazingly, within 3 weeks I started to grow a patch of hairs along the crown and also along the left side of my head that were as much as 5/16” long.

Sadly, for some reason which, the compounder was unable or unwilling to explain, the subsequent vials began acting like a quick               setting adhesive that literally glued clumps of hairs together. I had to very slowly and gently pry the hairs apart with my nails and then          only applying a little water could free them of the glue. But bottle after bottle, all of them had the same problem. Dr. D-one of the least  sympathetic and proactive dermatologists I’ve ever known (not that others were much better)-said that the compounded solution may     need more “oil or more alcohol”. More oil?

2.) Am I drinking enough water?  How many here found that their oral, nasal, patch or injectible estradiol worked better for them when         they drank 1 to 2 liters of pure water daily?  

3.) Am I overweight? My endocrinologist just weighed me at 149 lbs (clothes and shoes on). How many here found that their oral, nasal, patch or injectible estradiol worked better for them when they were at a certain weight? Checking my computer, I see that I was between 137 and 140 lbs when I had all of that hair regrowth.

4.) Recall that when I first began treatment, I was on one of those two estradiol valerate regimens, plus Premarin and Aldactone.            Can anyone offer any theories or personal experience for why using all three might not only help hair regrowth but may also again attenuate libido?

Does anyone here who had SRS still use any of the above? If yes, at what dose/frequency for Premarin and/or Aldactone?

5.) This may sound preposterous but might there be a reason (s) for why using Proscar (Finasteride) works better for most or some transwomen than does Dutasteride? Of course, most of us who are concerned with and kept well informed of hair regrowth strategies know that Dutasteride blocks two of the 4 or 5 reductase enzymes, while Proscar block only blocks one.

But is anyone aware of any empirical evidence showing where Proscar worked better than did Dutasteride for us, or even for                      a non-transgendered male? If yes, then at what dose/frequency?

6.) As for “up/down regulation”, my understanding is that it’s a feedback system that regulates (however disagreeably for transwomen)      the rate and/or duration at which a drug, herb or other substance is allowed by the body to work its intended effects upon the body before the body prevents those effects from being realized. That is, the intended and/or incidental bodily receptors (e.g. body, facial and scalp hair follicles, brain and/or adrenal components) become immune or desensitized to the presence of that substance and will no longer react as predicated or had otherwise did previously. https://en.wikipedia.org/wiki/Downregulation_and_upregulation

The big question is how long might it take a person’s body to reset itself to again become as previously receptive to the above the drugs, and thereby gain accordingly from their use?

For example, has anyone using Dutasteride, Finasteride, Aldactone, Androcur or even the estrogen Premarin, while previously enjoying their benefits against hair loss, later found them no longer effective? But then after some period of time (??) found them again to be as effective as before? If yes, about how long did it take for your body to reset? 

Also, do you perhaps follow some kind of rotation cycling among your choice of anti-androgens, so that while your body is desensitized       to one drug, it’s now receptive to the effects of another?

7.) What is the likelihood that Avodart brand Dutasteride would work better than the generic?

8.) If the above options 1 thru 4 don’t prove successful-whether or not I can de-stress my situation-and as I can’t wait around for Dr. Cotsarelis’ treatments http://www.hairlosscure2020.com/category/george-cotsarelis/ it looks like the last resort is Platelet Rich Plasma therapy. Though you get what you pay for is usually true, even if it did help, PRP sessions are brutally expensive. And who knows how many sessions I’d need, even with my surgery and years of anti-androgens? 

Have anyone here ever tried PRP long enough to offer a valid review? In any case, I’ve now lost too much hair to risk waiting for any remaining follicles to go dormant, much less die. I’m seeing another Garden City dermatologist this week to find out if PRP is cost-effective in my case.  I hope I haven’t bored anyone with my story. I also hope those suffering with androgenic or other types of hair loss may have picked up some clues here for what might help them.

 

 

 

 

Edited April 20, 2017 by Carolyn Marie
Dosage information deleted, per Rule 17 of the T & C's

[Carolyn Marie]

Welcome to the Playground, D & T.  I wanted to first point out that you will notice that all references to medication dosages in your post have been removed.  I hope that does not interfere with the purpose of your post.  But our rules on dosage info are quite specific and always enforced.  You may want to read the Community Rules when you have a chance.

That said, I hope that some of our members can be of assistance to you.  Also, please do post an introduction when you have time.  We would love to hear more about you.

HUGS

Carolyn Marie

[Guest Kaylee]

I have been on E for 2.5 years,  and Spiro and  Finisteride for  near 2. Additionally,  I have been using minoxidil with a micro needle roller and Nioxin shampoo for 3 years. I did notice an increase in hair growth (head),,  after months of using each item,  but over the last 8 months or  so have began thinning again. I have very short growth on my head,  despite the rest of my hair being mid length (so it's still growing to some extent),  but it never seems to thicken,  suggesting iy is still falling out to some extent. 

Based on your post,  I may ask my endo about your theory.  I know people can build up a tolorance for medications.  Perhaps that is what' is happening. 

Kaylee

[d&t]

On 4/20/2017 at 1:17 AM, Carolyn Marie said:

Welcome to the Playground, D & T.  I wanted to first point out that you will notice that all references to medication dosages in your post have been removed.  I hope that does not interfere with the purpose of your post.  But our rules on dosage info are quite specific and always enforced.  You may want to read the Community Rules when you have a chance. 

Sorry about that, Carolyn Marie. Naturally, I will obey your restrictions. However, while some may choose to self-medicate, I certainly never take Rx drugs-or even OTC drugs, at least in quantities and frequencies beyond the recommended limits stated on the packaging-without consulting my endo first. I'd like to think that anyone reading and contributing to those threads would at least be that intelligent and wise, no matter how desperate and scared we can all get at times.

Indeed, my only reason for either stating how much of what drugs I use and/or asking the same of others here was merely to gain and give useful feedback that might help me and others here against our very painful and seemingly hopeless battles against hair loss. To that end, I hope that my next post will be acceptable, and again helpful to all.  And thanks very much for your warm welcome to this wonderful forum.  

 

[d&t]

On 4/20/2017 at 11:58 AM, Kaylee said:

I have been on E for 2.5 years,  and Spiro and  Finisteride for  near 2. Additionally,  I have been using minoxidil with a micro needle roller and Nioxin shampoo for 3 years. I did notice an increase in hair growth (head),,  after months of using each item,  but over the last 8 months or  so have began thinning again. I have very short growth on my head,  despite the rest of my hair being mid length (so it's still growing to some extent),  but it never seems to thicken,  suggesting iy is still falling out to some extent. 

Based on your post,  I may ask my endo about your theory.  I know people can build up a tolorance for medications.  Perhaps that is what' is happening. 

Kaylee

 

[d&t]

Hmmmm...why can't i edit or delete my posts? There's no buttons to click on to do this here as there are at other forums.

[d&t]

The hormone therapies (estradiol valerate) and anti-androgens  (dutasteride) that many of us here have used for many years will successfully minimize testosterone production, even for those without orchiectomy. 

But what of the androgens that are secreted by the zona reticularis, and perhaps even more so when under stress? https://en.wikipedia.org/wiki/Zona_reticularis I'm no expert, but as far as I know there is no way to

actually suppress androgen production from the adrenal glands, other than reducing one's stress levels and getting enough sleep to minimize cortisol levels (often easier said than done).

 

But in any case, while there are many other reasons for hair loss, in the fight against androgenic hair loss we should not overlook the potential power of androgen receptor blockers. Spironolactone and Cimetidine may not be able to suppress androgen production well, if at all, but they can help to prevent DHT from binding to the hair follicles by apparently being as good of a "hair receptor chemistry "fit" as is DHT.

https://www.dermhairclinic.com/cimetidine-tagamet-hair-loss-drug/ So as long as we are doing as much as we can to minimize DHT production, using Spironolactone and/or Cimetidine may help protect against androgenic-induced hair loss.

As for parts of the scalp where DHT or other diseases (e.g. auto immune inflammatory, nutrient deficiencies, thyroid issues, et al) have killed follicles, let us hope that these trials will actually begin

here in the USA next year. https://www.forbes.com/sites/jboyd/2016/07/13/stem-cells-to-make-hair-today-gone-tomorrow-a-thing-of-the-past/#59f00ae45c04 

http://www.belgraviacentre.com/blog/shiseido-partners-with-replicel-to-launch-hair-loss-cure-in-2018/

But for now I do have one question. Why do so many of us at this and other transgender forums use Finasteride when numerous studies have consistently shown that Dutasteride works better to prevent androgenic hair loss, as it blocks all three of the reductase enzymes?

Or has anyone here actually found that Finasteride works better than Dutasteride?

Also, has anyone used either Fin or Dut for long periods with success, then found that it stopping preventing hair loss, then switched to the other drug and found that it worked?

 

[VickySGV]

38 minutes ago, d&t said:

Hmmmm...why can't i edit or delete my posts? There's no buttons to click on to do this here as there are at other forums.

Only moderators or Admins can edit posts on our forums.  In the early days (before I was here 6 years ago) mods or admins would approve posts with possible editing for restricted items such as dosages of medications only to find the illegal information back in them hours later after initial approval.  You may ask any of us on the Mod/Admin crew to change something for you and if it does not make the post fly against the posting rules, we will happily do so for you.  PM us at will. 

As for people using one medication versus another, unless it is an OTC medication, they are at the mercy of their medical team as far the prescribed medications go, and it is one area where medical practice is a bit of an individual art for doctors and pharmacists.  At the present time there is very little finished research overall on Cross Gender hormones and what there is may not be on the immediate read or die list for the medical providers.

One item that I may have overlooked above but did not readily see is that hair grows in cycles, with each cycle including a dormancy period when the hair has normally finished growing and the root has fallen out.  The follicle will be dormant for a time built into its genetic timer, but will begin re-growing at some point in the future.  It took me nearly 5 years to fully cycle all  of my hair, and as mine did, it was much finer in texture, but except for a couple of places high on my temples, and a tiny bit on my forehead it is all there.